In describing the model, we will present a combination of outlines, powerpoints, and tables that explains the theory, concepts, and application to nursing.
Dorothea Orem and Theory in the Making...
Overview of Orem's Self-Care Deficit Theory of Nursing
What is the key "problem" or focus of the model/framework?
According to Polit & Henderson, each individual has the ability to perform self-care, and are responsible for their health and the health of their dependents. Self-care is "the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being" (as cited in Cardinal Stritch University Library, 2011).
Orem's initial definition of nursing's concern included "man's need for self-care action and the provision and management of it on a continuous basis in order to sustain life and health, recover from disease or injury, and cope with their effects" (Orem, 1959, p. 3).
More simply stated, her definition of nursing's goal was "overcoming human limitations" (Orem, 1959, p. 4)
Orem's general theory of self-care deficit nursing states that a self-care demand exists when the patient of family members are not able to provide care for him/herself and those self-care demands can be met by the nurse (Masters, 2011).
According to Sitzman & Eichelberger (2011), "Orem's Self-Care Model describes a structure wherein the nurse assists the client, where needed, to maintain an adequate level of self-care. The degree of nursing care and intervention depends on the degree to which the client is able (or unable) to meet self-care needs (p. 96)."
Orem's theory is made up of 3 related theories:
1. Theory of Self-Care
2. Theory of Self-Care Deficit
3. Theory of Nursing Systems
According to Orem, "the three-part theory focuses not on individuals, but on persons in relations. Each of the three theories has as its focus a specific dimension of the person: the theory of self-care focuses on the self, the I; the theory of self-care deficit focuses on you and me; and the theory of nursing system focuses on we, persons in community" (1990, p. 49).
Theory of Self-Care Deficit and Theory of Nursing Systems are both on the same powerpoint below.
How are the three theories related?
The theory of self care delineates the demands of self-care requisites that an individual needs to meet in order to stay healthy or get better from illness. When a person cannot meet these self-care demands, or when self-care requisites exceeds self-care capabilites, nursing is needed. Nurses can help patients meet their self-care needs by utilizing the 5 methods in the Theory of Self Care Deficit. However, the nurse must properly assess the level of self-care a patient requires so that the nurse can utilize the nursing system (as stated in the Theory of Nursing System) that best fits the patient's ability to perform self-care. In the end, the nurse assists the patient in meeting his/her self-care needs so that he/she is healthy and free of illness.
LETS PICTURE IT!
Major Concepts of Nursing according to Orem
Nursing theories have four concepts that are central to their metapardigm: person, environment, health, and nursing. However, each nurse theorist defines these concepts differently, depending on their fit into the theory. Below is a powerpoint that outlines Orem's definitions of these 4 concepts.
How are the four concepts related?
The person (or patient) is the central focus of nursing care. According to Orem, the person's health state is mediated by his/her environment. A person, who is healthy, is capable of self-care. When there is illness in the person's health state, the person is not able to complete all self-care requisites. When this occurs, nursing care is needed to assist the person in completing his/her self-care. Nurses must assess the person's ability to provide his/her own self care and the environmental context of the person in order to overcome health-associated limitations.
Orem's Self-Care Deficit Nursing Theory as a THEORETICAL FRAMEWORK for Nursing Practice
Assumptions and Propositions
Using Orem’s Theory in Practice
Who developed this theoretical model and what did they use the theory to examine?
Cardinal and Stritch University Library. (2011). Dorothea Orem 1914- Self-care Framework. Retrieved from:http://library.stritch.edu/research/subjects/health/nursingTheorists/orem.html
Masters, K. (2011). Nursing Theories: A Framework for Professional Practice. Sudbury, MA: Jones and Bartlett Learning, LLC.
Nursing Theories. (2011). Dorothea Orem's Self-care Theory. Retrieved from: http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
Orem, D. (1959). Guides for developing curriculum for the education of practical nurses. Washington, DC: U.S. Government Printing Office.
Orem, D. (1990). A nursing practice theory in three parts, 1956-1989. In M. E. Parker (Ed.), Nursing theories in practice (p. 47-60). New York: National league for Nursing.
Sitzman, K. L. & Eichelberger, L. W. (2011). Understanding the Works of Nurse Theorists: A Creative Beginning (2nd ed.). Sudbury, MA: Jones and Barlett Learning, LLC.